U.S. patent application number 13/472893 was filed with the patent office on 2012-12-06 for biased accommodating intraocular lens.
Invention is credited to James Stuart Cumming.
Application Number | 20120310344 13/472893 |
Document ID | / |
Family ID | 47262260 |
Filed Date | 2012-12-06 |
United States Patent
Application |
20120310344 |
Kind Code |
A1 |
Cumming; James Stuart |
December 6, 2012 |
Biased accommodating intraocular lens
Abstract
An accommodating intraocular lens has a lens optic that is
coupled to at least one haptic and is anteriorly biased with
respect thereto.
Inventors: |
Cumming; James Stuart;
(Laguna Beach, CA) |
Family ID: |
47262260 |
Appl. No.: |
13/472893 |
Filed: |
May 16, 2012 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
61519098 |
May 17, 2011 |
|
|
|
Current U.S.
Class: |
623/6.44 ;
623/6.46 |
Current CPC
Class: |
A61F 2220/0091 20130101;
A61F 2002/1681 20130101; A61F 2/1629 20130101; A61F 2/1624
20130101; A61F 2002/1689 20130101; A61F 2/1635 20130101 |
Class at
Publication: |
623/6.44 ;
623/6.46 |
International
Class: |
A61F 2/16 20060101
A61F002/16 |
Claims
1. An accommodating intraocular lens comprising: a lens optic
coupled to at least one haptic; wherein the optic is biased with
respect to the haptic.
2. The accommodating intraocular lens of claim 1, wherein the bias
is an anterior bias.
3. The accommodating intraocular lens of claim 1, wherein the bias
is a posterior bias.
4. The accommodating intraocular lens of claim 1, further
comprising a flexion operable to bias the optic with respect to the
haptic.
5. The accommodating intraocular lens of claim 4, wherein the
flexion comprises a proximal end of the haptic set at a
non-straight angle with respect to a distal end of the haptic.
6. The accommodating intraocular lens of claim 1, wherein the lens
optic is flexibly coupled to the haptic.
7. The accommodating intraocular lens of claim 1, further
comprising one or more hinges flexibly coupling the lens optic to
the haptic.
8. The accommodating intraocular lens of claim 1, wherein the
haptic is a plate haptic.
9. The accommodating intraocular lens of claim 1, wherein the
haptic is substantially longitudinally rigid and is flexible
transversely.
10. The accommodating intraocular lens of claim 1, further
comprising projections extending laterally from the haptic so as to
engage a capsular bag when the lens is inserted into an eye.
11. The accommodating intraocular lens of claim 1, wherein the lens
optic is a single focus lens optic.
12. The accommodating intraocular lens of claim 1, wherein the
haptic is flat.
13. The accommodating intraocular lens of claim 1, wherein the
haptic is curved.
14. The accommodating intraocular lens of claim 1, wherein the
haptics comprise distal ends substantially anterior to proximal
ends.
15. The accommodating intraocular lens of claim 1, further
comprising: a first plate haptic positioned at a twelve o'clock
position within an eye; and a second plate haptic positioned at a
six o'clock position within the eye; wherein the first plate haptic
comprises a frame operable to cause the first plate haptic to be
substantially rigid in the longitudinal direction and flexible in
the transverse direction.
16. The accommodating intraocular lens of claim 15, wherein the
second haptics does not comprise the frame.
17. The accommodating intraocular lens of claim 15, wherein the
second haptics also comprises the frame.
18. The accommodating intraocular lens of claim 1, wherein the
optic is flexible.
19. An accommodating intraocular lens comprising: a single focus
lens optic coupled to opposing plate haptics having proximal and
distal ends and a frame located therein, the frame comprising a
flexion that sets the proximal and distal ends in a non-zero angle
with respect to each other so as to bias the optic with respect to
the haptics; at least one projection extending laterally from the
distal end of each plate haptic; one or more connecting portions
coupling each haptic to the optic, the connecting portions having
one or more hinges thereon.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application is based on U.S. Provisional Application
No. 61/519,098, filed on May 17, 2011, the contents and disclosures
of which are fully incorporated herein by reference.
BACKGROUND OF THE INVENTION
[0002] Premium intraocular lenses (IOLs) implanted during cataract
surgery are categorized three ways: accommodating, multifocal and
toric intraocular lenses.
[0003] The best visual acuity is achieved with the single focus
accommodating lenses. The optic of these lenses moves forward and
backward upon constriction and relaxation of the ciliary muscle.
However, for reading in dim lighting conditions, or for small
print, week reading glasses are often necessary.
[0004] The multifocal lenses focus light on the retina at either
two or three focal lengths. Thus, there is more than one image on
the retina simultaneously. This creates problems since the amount
of light in focus is divided between the multiple focal points, and
contrast sensitivity is thereby reduced, making vision at all
distances difficult in dim lighting. In addition, there are severe
problems when driving at night when the pupil is dilated. Many
patients experience severe glare and halos and many have had to
have the multifocal lenses explanted and replaced with a single
vision standard lens, because of this problem. However, the near
vision with the multifocal lenses is superior to that of the
current accommodating lens.
[0005] The toric lenses correct the eyes that have significant
astigmatism.
[0006] The currently marketed plate accommodating intraocular
lenses provide excellent distance and intermediate vision but
sometimes require weak, +1.00, reading glasses for prolonged
reading, for seeing small print, or reading in dim lighting
conditions.
[0007] Furthermore, it is important for intraocular lenses to have
a consistent location along the axis of the eye to provide good
uncorrected distance vision and to center in the middle of the
vertical meridian of the eye. Without excellent uncorrected
distance vision there is no point in implanting lenses designed to
give seamless vision from far to near.
[0008] The original intraocular lens consisted of a single optic.
These lenses frequently de-centered and dislocated and it was
discovered that there was a need to center and fixate the lens
optic in the vertical meridian of the eye.
[0009] Attachments to the optic that center and fixate the lens
within the capsular bag are called haptics. Traditionally, haptics
consist of multiple flexible loops of various designs, J loops, C
loops, closed loops and flexible radial arms. Recently, traditional
haptics have been replaced in some lens designs with oblong, flat
flexible plates, called plate haptics. These plate haptics usually
made from silicone, are solid, flat, flexible and between 3.0 and
6.0 mm in width, 0.20 to 0.75 mm thick, and may have tapered,
rounded or parallel sides. Plate haptics often have flexible loops
or fingers that help center and fixate the lens within the capsular
bag. These flexible fingers extend beyond the distal or outer end
of the plate haptics and slightly beyond the diameter of the
capsular bag and are designed to flex centrally to center and
fixate the lens and its optic within the capsular bag.
[0010] An intraocular lens (IOL) is a lens implanted into the eye,
usually replacing a normal human lens that has been clouded over by
a cataract, or can replace a normal human lens as a form of
refractive surgery to change the eye's optical power.
[0011] An accommodating IOL (AIOL) permits refocusing of the eye by
means of movement along the optical axis in response to the
constriction or relaxation of ciliary muscles. Near vision results
from a forward movement of the optic upon constriction of the
ciliary muscle which increases the pressure in the posterior part
of the eye with a simultaneous decrease in pressure in the anterior
part of the eye. Distance vision results from the reverse pressure
change that takes place upon relaxation of the ciliary muscle and
the resultant backwards movement of the lens. The movement of the
optic enables the patient implanted with the lens to automatically
change their vision between far, intermediate and near.
[0012] AIOLs are known to consist of opposing haptics positioned on
either side of a lens optic. Once a patient's cataract is removed,
by e.g. phacoemulsification, the IOL is placed into the empty
capsular bag. The haptics help to center the IOL and fixate it
within the capsular bag by fibrosis. Such AIOLs are described in
U.S. Pat. No. 5,674,282, U.S. Pat. No. 5,476,514, and U.S. Pat. No.
5,496,366, to Cumming, herein incorporated by reference in its
entirety.
[0013] And although current AIOLs provide patients with
significantly restored distance and intermediate vision, adequate
near vision is commonly lacking--often requiring that patients use
weak reading glasses to enhance near vision. Multi-focal and toric
lens solutions suffer from the disadvantages identified above.
SUMMARY OF THE INVENTION
[0014] An accommodating intraocular lens according to an embodiment
of the present invention is described that overcomes the
deficiencies of present designs noted above.
[0015] The field of the invention is a single focus accommodating
intraocular lens that provides seamless vision from distance to
near automatically by relaxation and constriction of the ciliary
muscle.
[0016] An accommodating intraocular lens is provided whose lens
optic is coupled to at least one haptic and is biased with respect
thereto. The accommodating intraocular lens may have an optic
coupled to a plate haptic via a member that substantially promotes
the optic's response to a vitreous pressure change.
[0017] Other features and advantages of the present invention will
become apparent from the following more detailed description, taken
in conjunction with the accompanying drawings, which illustrate, by
way of example, the principles of the presently described apparatus
and method of its use.
BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING(S)
[0018] Illustrated in the accompanying drawing(s) is at least one
of the best mode embodiments of the present invention In such
drawing(s):
[0019] FIG. 1 illustrates a side plan view of an AIOL as inserted
into a human eye, according to at least one embodiment of the
present invention;
[0020] FIGS. 2A and 2B illustrate top plan views of various AIOLs
according to at least one embodiment of the present invention;
[0021] FIGS. 3A and 3B illustrate side plan views of AIOL vaulting
according to at least one embodiment of the present invention;
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0022] The above described drawing figures illustrate the described
invention in at least one of its preferred, best mode embodiment,
which is further defined in detail in the following description.
Those having ordinary skill in the art may be able to make
alterations and modifications to what is described herein without
departing from its spirit and scope. Therefore, it should be
understood that what is illustrated is set forth only for the
purposes of example and should not be taken as a limitation on the
scope of the present invention.
[0023] A preferred embodiment will now be described with reference
to FIG. 1.
[0024] An accommodating intraocular lens (AIOL) 100 comprises: an
optic 200 coupled to at least one haptic 300 such that the optic
200 is biased with respect to the haptic 300.
[0025] The AIOL 100 is placed into the capsular bag of a patient's
eye after cataract surgery via known techniques such as, for
example, phacoemulsification. The lens is centered so that the
optical axis of the lens coincides with that of the patient's eye.
The haptics 300 contact the capsular bag and the natural fibrosis
of the tissue secures the haptics 300, and consequently the AIOL
100, in place.
[0026] The optic 200 is preferably a single focus optic that
gathers the incoming light and focuses it on the retina of the
patient so as to effect vision. The optic 200 may be bioconvex,
refractive, diffractive, plano-convex, Fresnell, spheric, aspheric,
toric, or of any other type that is substantially single focus. In
order to permit the optic 200 to be inserted into the eye through a
small incision, the optic 200 is preferably made of a flexible
optical material, such as, for example, silicone, acrylic,
hydrogel, or other flexible optical material now known or hereafter
developed.
[0027] As shown in FIG. 1, the optic 200 is coupled to at least one
haptic 300 having distal 320 and proximal 340 ends. A flexion 342
biases the optic 200 with respect to the distal end 320 of the
haptic 300, and comprises the proximal end 340 set at a
non-straight angle with respect to the distal end 320.
[0028] In a preferred embodiment, the flexion 342 biases the optic
200 anteriorly with respect to the distal end 320 and sets a
positive angle between the proximal 340 and distal 320 ends, as
measured from the direction of the optic 200. Thus, while the
inserted AIOL 100 is in a neutral state (i.e. one with little to no
vitreous pressure applied in either direction) the optic 200 is
anteriorly biased--that is, the optic 200 is more anterior (or
forward) than the proximal end 340 of the haptic 300.
[0029] In an alternative embodiment, the flexion 342 biases the
optic 200 posteriorly with respect to the distal end 320 and sets a
negative angle between the proximal 340 and distal 320 ends, as
measured from the direction of the optic 200. Thus, while the
inserted AIOL 100 is in a neutral state the optic 200 is
posteriorly biased--that is, the optic 200 is more posterior (or
rearward) than the proximal end 340 of the haptic 300.
[0030] In some embodiments, the optic 200 may be coupled in series
with opposing haptics 300 and may be anteriorly biased with respect
to one while posteriorly biased to the other. However, whether
wholly posterior, wholly anterior, or partially posterior and
partially anterior, the bias operates to increase the range of
accommodation that would otherwise be present, as discussed herein.
For example, with an anterior bias the optic 200 requires less
vitreous pressure and ciliary muscle contraction to move to the
same forward position as without the bias. Thus, patients whose
eyes are not able to exert the necessary pressure for optimal near
vision with non-biased AIOLs can nonetheless exert the pressure
required for optimal near vision with anteriorly biased AIOLs
100.
[0031] Turning again to FIG. 1, the haptic 300 may be coupled to
the optic via a connecting portion 360 made of the same flexible
material of the optic 200. The connecting portion 360 may comprise
a hinge 362 that traverses the connecting portion 360 that operates
to weaken the connecting portion 360 so that vitreous pressure and
end-to-end compression of opposing haptics 300 can stretch the base
of the hinge 362 like an elastic band to allow the optic 200 to
move forward. This increases the range of focusing
abilities--especially in the near range. Because the lens can move
further forward, near focus is improved. The connecting portion 360
may also comprise one or more straps. The straps further assist in
accommodation in that they decrease the resistance to the pressure
that pushes the optic forward. Exemplary connecting portions are
described in U.S. patent Ser. Nos. 13/017,189; 13/092,359;
13/111,599; and 13/155,327, incorporated herein by reference in
their entireties.
[0032] In at least one embodiment, the connecting portion 360, for
example, the flexible extension of the optic 200 coupling the optic
to the haptic 300, may have a flexible hinge 362 extending
transversely across either or both sides.
[0033] Turning now to FIGS. 2A and 2B, the at least one haptic 300
is preferably a plate haptic comprising: a body 310, having distal
320 and proximal 340 ends angularly set so as to form the
substantially rigid flexion 342.
[0034] The plate haptic 300 may comprise projections 384, the
haptic and projections operable to engage, fixate and center the
haptic into the capsular bag. Since, on insertion into the eye, the
AIOL is vaulted posteriorly, the plate haptic moves centrally and
posteriorly in response to ciliary muscle contraction, as shown in
FIGS. 3A and 3B, such movement, combined with the change in
vitreous pressure, causing the optic to vault anteriorly. The
haptic body may be substantially flexible in the transverse
direction and substantially rigid in the longitudinal direction so
as to enable the AIOL 100 to be folded and inserted into the eye
via a small incision. One of ordinary skill will appreciate that
while substantial rigidity may promote vaulting; the degree of
rigidity imposed is not intended to preclude an effective vault of
the optic at the connecting portion 360. It is preferable that the
haptic body be constructed of the same or similar flexible material
as the optic, including, but not limited to: silicone, hydrogel,
acrylic, or similar material. Non-biased plate haptics having
similar features are discussed in U.S. patent Ser. Nos. 13/017,189;
13/092,359; 13/111,599; and 13/155,327, incorporated herein by
reference in their entireties.
[0035] Returning now to FIGS. 2A and 2B, a frame 380 may be
embedded within the haptic body so as to promote the longitudinal
rigidity thereof. The frame 380 may be formed of polyimide,
prolene, polymethylmethanylate (PMMA), titanium, or similar
material. Such exemplary frames are discussed in U.S. patent Ser.
Nos. 13/017,189; 13/092,359; 13/111,599; and 13/155,327,
incorporated herein by reference in their entireties. As shown in
FIGS. 2A and 2B, the frame 380 may comprise an anchor 382 extending
into the proximal end 340 of the haptic 300 and forming the flexion
with the distal end 320 and associated rest of the frame 380. The
anchor 382 operates to set and maintain the angle of the flexion
342.
[0036] As shown in FIGS. 2A and 2B, the haptic 300 may comprise
projections 384, or fingers, extending from the distal end 320 to
engage the capsular bag and secure and center the AIOL 100 thereto.
The projections 384 may be homogeneous with the frame 380 and may
be made of either polyimide, PMMA, acrylic or any other inert
material. In some embodiments, the projections may be molded into
the flexible plate haptic 300 as a T-shaped cross bar projection.
Such exemplary projections are discussed in U.S. patent Ser. Nos.
13/017,189; 13/092,359; 13/111,599; and 13/155,327, incorporated
herein by reference in their entireties.
[0037] As discussed herein, the haptic 300 may be coupled to the
optic via connecting portion 360 that operates to permit
contraction of the ciliary muscles to cause an end-to-end
compression of opposing haptics with an increase in vitreous
pressure, thus moving the optic substantially forward.
[0038] In at least one embodiment, the longitudinal length of the
IOL (i.e. from distal end to distal end) may be between
approximately 9.0-11.0 mm, with the diameter as measured from the
tips of the lateral projections being between approximately
11.5-12.0 mm. The haptics 300 are preferably between 3.0-6.0 mm
wide and 0.20-0.75 mm thick, while the optic may be approximately
5.0 mm.
[0039] In a preferred embodiment, the plate haptic 300 are designed
to be flexible transversely, but rigid longitudinally. At the
distal ends 320 of the plate haptics 300 are transverse flexible
arms 384 designed to center and fixate the AIOL 100 within the
capsular bag. The rigid polyimide frame 380 molded within the plate
haptic may be flexed anteriorly at the proximal end and is designed
to push the edge of the optic 200 forwards upon end-to-end
compression of the AIOL 100 with contraction of the ciliary
muscle.
[0040] In at least one embodiment, the rigid plate haptics 300 are
flat, with the rigid flexion 382 in the longitudinal rigid frame
380 molded into the transversely flexible plate haptic 300, the
flexion 382 being located at the proximal end 320 of the haptic
body 310 across the width of the rigid components 380 in the haptic
body 310, as seen, for example, in FIG. 1.
[0041] In at least one embodiment, the plate haptic 300 is curved,
with a rigid curve in the longitudinal rigid frame 380 molded into
the transversely flexible plate haptic 300, as seen, for example in
FIGS. 3A and 3B. In at least one embodiment the longitudinally
rigid plates 300 are bowed backwards when the AIOL 100 is placed
into the eye.
[0042] In at least one embodiment, the optic 200 will move forward
upon constriction of the circular ciliary muscle which increases
vitreous pressure and with the reduction in its diameter applies
end-to-end pressure on the haptics 300. Relaxation of the ciliary
muscle causes an increase in the diameter of the ciliary muscle and
a reduction in vitreous cavity pressure with an increase in
pressure in the anterior part of the eye such that the optic 200
moves posteriorly to the distant vision position.
[0043] Turning now to FIG. 5, the AIOL 100 is shown where the optic
200 is coupled in series to opposing plate haptics 300--one rigid
and one flexible, the rigid plate haptic being positioned at the 12
o'clock position in the eye and the flexible plate haptic being
positioned at the 6 o'clock position in the eye. As discussed
herein, the rigid plate haptic 300 preferably comprises a frame 380
that in turn preferably comprises the flexion 382 located at the
proximal end 320 biasing the optic 200 such that the center of the
optic 200 is anterior, or in front of the plate haptic 300 having
such a flexion 382. The proximal end 320 of the rigid plate haptic
300 may be molded into the connecting portion 360--which may be a
flexible extension of the optic 200--during the manufacturing
molding process. Further, as discussed herein, each plate haptic
300 may have one or more flexible projections or fingers 384
extending from the distal ends 320 thereof. Still further, as
discussed herein, respective hinges 362 of the connecting portions
360 of both haptics 300 are preferably provided so as to permit
improved response to vitreous pressure changes. As discussed
herein, one or more straps may couple the plate haptic 300 to the
optic 200. The straps may comprise grooves or hinges that traverse
the strap and promote accommodation.
[0044] The enablements described in detail above are considered
novel over the prior art of record and are considered critical to
the operation of at least one aspect of the invention and to the
achievement of the above described objectives. The words used in
this specification to describe the instant embodiments are to be
understood not only in the sense of their commonly defined
meanings, but to include by special definition in this
specification: structure, material or acts beyond the scope of the
commonly defined meanings. Thus if an element can be understood in
the context of this specification as including more than one
meaning, then its use must be understood as being generic to all
possible meanings supported by the specification and by the word or
words describing the element.
[0045] The definitions of the words or drawing elements described
herein are meant to include not only the combination of elements
which are literally set forth, but all equivalent structure,
material or acts for performing substantially the same function in
substantially the same way to obtain substantially the same result.
In this sense it is therefore contemplated that an equivalent
substitution of two or more elements may be made for any one of the
elements described and its various embodiments or that a single
element may be substituted for two or more elements in a claim.
[0046] Changes from the claimed subject matter as viewed by a
person with ordinary skill in the art, now known or later devised,
are expressly contemplated as being equivalents within the scope
intended and its various embodiments. Therefore, obvious
substitutions now or later known to one with ordinary skill in the
art are defined to be within the scope of the defined elements.
This disclosure is thus meant to be understood to include what is
specifically illustrated and described above, what is conceptually
equivalent, what can be obviously substituted, and also what
incorporates the essential ideas.
[0047] The scope of this description is to be interpreted only in
conjunction with the appended claims and it is made clear, here,
that the named inventor believes that the claimed subject matter is
what is intended to be patented.
* * * * *